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Tigecycline: an overview and update

Joseph M Blondeau

Tigecycline is the first novel broad-spectrum glycylcycline antimicrobial agent. This agent has been shown to have broad spectrum in vitro activity against Gram-positive and -negative bacteria, atypical pathogens, anaerobic bacteria and organisms that have become resistant to other antimicrobial agents. Specifically, tigecycline is active against: Escherichia coli – including extended spectrum b-lactamase producing strains; Staphylococcus aureus – including methicillin-resistant strains; Enterococcus – including vancomycinresistant strains; and Streptococcus pneumoniae – including penicillin-resistant strains and tetracyclineresistant strains in vitro. Characteristics of the drug include: it is bacteriostatic, it is given via intravenous administration and twice-daily dosing, it has a post-antibiotic effect and good tissue penetration, and no dosage adjustment for renal or hepatic impairment is needed. Tigecycline has been shown to be efficacious for treatment of complicated skin and soft-tissue infections, for complicated intra-abdominal infections and, more recently, has been approved in Canada for the treatment of community-acquired pneumonia requiring hospitalization. Additionally, this drug has a safety profile comparable with other agents and classes of antimicrobial agents. The most common side effects reported from clinical trials with tigecycline include nausea (24.4%), vomiting (19.2%) and diarrhea (13.8%), and these values are similar or more frequent than that seen with comparator agents.